Long-term Outcome of the Retrourethral Transobturator Male Sling After Transurethral Resection of the Prostate

Kretschmer, Alexander; Buchner, Alexander; Leitl, Benedikt; Grabbert, Markus; Sommer, Anne; Khoder, Wael; Gozzi, Christian; Stief, Christian G. und Bauer, Ricarda M. (2016): Long-term Outcome of the Retrourethral Transobturator Male Sling After Transurethral Resection of the Prostate. In: International Neurourology Journal, Bd. 20, Nr. 4: S. 335-341

Abstract

Purpose: To evaluate long-term outcomes of AdVance and AdVanceXP male slings in patients with persistent stress urinary incontinence (SUI) after transurethral resection of the prostate (TURP). Methods: A total of 18 consecutive patients received AdVance (n =14) or AdVanceXP (n = 4) male sling implantation between 2007 and 2013. Continence was determined by pad use, 24-hour pad testing and validated questionnaires (International Consultation on Incontinence Questionnaire Short Form, ICIQ-SF). Quality of life was evaluated by International Quality of Life (IQoL) score. Patient satisfaction was measured with patient's global impression of improvement score. Cure was defined as 0-5 gin the 24-hour pad test. Statistical analysis included Fisher exact and Wilcoxon test (P < 0.05). Results: Follow-up was available for 15 patients who underwent further analysis. After a median follow-up of 70 months (range, 18-83 months), mean daily pad usage was 1.8 +/- 2.1 pads (P = 0.015 vs. baseline level). Mean IQoL score was 66.4 +/- 31.6 (P = 0.050 vs. baseline level), and mean ICIQ-SF score was 9.5 +/- 6.6 (P = 0.077 vs. baseline level). Based on 24-hour pad testing, mean daily urine loss was 31.2 +/- 64.5 g (median, 0 g;range, 0-209 g). Cure rate was 46.7%, and cure-and-improved rate was 60.0%. Assessing predictive features for success, better results were found in patients who needed up to 4 pads preoperatively (P = 0.041) as well as for patients 71 years at the time of implantation (P = 0.041): Conclusions: The findings indicate that AdVance and AdVanceXP implantation can be performed effectively and safely in men suffering from SUI after TURP. However, long-term success rates seem to be lower compared to SUI after radical prostatectomy and patients should be counseled accordingly.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 2093-4777
• Sprache: Englisch